Fat and Stromal Vascular Fraction of Adipose Tissue in Reconstructive and Regenerative Surgery: 5 Years Experience

MAteRiAlS AND MethODS: Since 2010, fat grafting was performed in 140 patients. Posttraumatic, postoperative, and postirradiated contour deformities were treated in 74 cases (breast, 31; head and neck, 27; and other localizations, 16). In 61 patients, fat was injected to promote chronic wound healing (venous ulcers, 22; diabetic ulcers, 17; radiation wounds, 16; and other etiology, 6). Adipose-derived stromal vascular fraction (SVF) injection was utilized in 11 patients: knee joint osteoarthritis, 7; radiation rectovaginal fistula, 2; rectum radiation wound, 1; and right leg chronic wound (Wegener’s granulomatosis), 1. Fat was harvested by liposuction. Lipoaspirate was centrifuged with 1200g during 3 minutes. Liquid fraction and oil were removed. Coleman type 1 and 3 cannulas of 0.8, 1.0, 1.2, 1.6, and 2.0 mm diameter were used to inject purified fatty tissue. Occasionally sharp needle was used. Digestion with collagenase type II was performed to isolate stromal-vascular cell fraction. Stromal cell sediment was then resuspended in a saline solution and injected with sharp 18to 27-gauge needles. A small sample was taken out of the obtained cells to characterize final product by means of flow cytometry. Conventional treatment methods were used in all cases before experimental technique was applied.